Healthiest Wisconsin 2020 Wisconsin State Prevention Conference Healthy Wisconsin 2020: Everyone Living Better, Longer – Aligning and Engaging With Wisconsin’s State Health Agenda Margaret Schmelzer, MS, RN June 14, 2011 Wisconsin Dells, Wisconsin
Learner Objectives • Understand the purpose and features of HW2020 • (Who, What, When, Where, Why, How) • Understand HW2020 as a flexible menu to ensure value and achieve outcomes: • Align and engage • Assure effective actions • Select and combine objectives • Gain knowledge and comfort to emerge as a champion and take steps to align your agency, organization to Healthiest Wisconsin 2020.
Consider . . . • “None of us act expect to act on more than a tiny corner of the great complexity. But in our interrelated society, itself part of an uncompromising independent world, we have to think about the whole complexity in order to act relevantly on any part of it. • Harlan Cleveland “The Knowledge Executive”
Improving Health Takes the Work of Many • Government cannot achieve the goals of HW2020 alone. • Nonetheless, government has the responsibility to establish leadership and facilitate the achievement of the public health mission and vision. • It takes the work of many to improve • the health of all.
Why do we Need a StatewidePublic Health Agenda? • Data Highlights
How Does Wisconsin Rank? • Wisconsin dropped from 11th best in 2009 to 18th in 2010 (a drop from 7th best in 1990). Source: America’s Health Rankings, United Health Foundation, 2010 http://www.americashealthrankings.org/yearcompare/2009/2010/WI.aspx
Why Do We Need HW2020? Data Highlights: • Wisconsin ranked 23rd among states in a combined measure of infant health in 2007. • Wisconsin ranked 28th in a combined measure of elder health in 2007. • Source: Healthiest Wisconsin 2020, Main Plan, page 36
Why? HW2020 Data Highlights • Wisconsin ranked worst among states for adult binge drinking, worst for current alcohol use among youth, 3rd in binge drinking among youth, and fourth in the incidence of youth riding with a driver who had been drinking. • Source: Healthiest Wisconsin 2020, Main Plan, page 36
Why? HW2020 Data Highlights • Milwaukee had the 2nd highest rate of sexually transmitted disease, Chlamydia, among the largest 50 states in the nation in 2007. Milwaukee’s rate was 50% higher than Chicago’s. • Source: Healthiest Wisconsin 2020, Main Plan, page 36
Why? HW2020 Data Highlights • Cardiovascular disease is consistently the leading cause of mortality for Wisconsin residents, accounting for more than 16,000 deaths annually, or 35% of all deaths. The Burden of Cardiovascular Disease in Wisconsin, 2005
Why? HW2020 Data Highlights • Many Wisconsin rivers and lakes are covered by fish consumption advisories because of mercury contamination. 85 percent of our residents include fish in their diets. Nearly half enjoy eating locally caught game fish. Mercury remains an important source of harmful exposure. Health Indicators Report: The State of Environmental and Occupational Health in Wisconsin 2007
Why? HW2020 Data Highlights • From 1993 to 2007, the number of births to Wisconsin teens aged 15-19 declined by 12%, from 7,057 to 6,240 births. Wisconsin Youth Sexual Behavior and Outcomes, 1993-2007 • Five types of injuries cause the greatest number of deaths: falls, suicide, motor vehicle crashes, poisoning and homicide.
Why? HW2020 Data Highlights • In Wisconsin, 7% of people 16 years of age and older lack basic writing skills. At the county level, the rates are projected to range from 4% to 11%. National Center for Education Statistics, 2006. • Low health literacy costs the Wisconsin economy an estimated $3.4 billion to $7.6 billion annually.Vernon, 2007.
Why? HW2020 Data Highlights • Race/Ethnicity Graduation Rate 2007-2008: • Blacks/African Americans 67% • American Indians 75% • Hispanics/Latinos 75% • Asians 90% • Whites 93% Wisconsin Department of Public Instruction
Why? HW2020 Data Highlights • Parents with low literacy skills are less likely to take their children for well-child visits and report fewer dental check-ups for themselves and their children. • They struggle to understand health risks, manage their own health and the health of their family. U.S. Office of Disease Prevention and Health Promotion, 2007.
Why? HW2020 Data Highlights • Wisconsin ranks 23rd in the nation in terms of income inequality. Blacks/African Americans reported household income levels that were 41.6% below the state median household income in 2005 Center on Wisconsin Strategy, 2008
Why? HW2020 Data Highlights • Hispanics/Latinos reported a median income 20.1% below the median for all households, while Whites reported household incomes 3.3% above than the median Center on Wisconsin Strategy, 2008
Why? HW2020 Data Highlights • Overall, 13% of Wisconsin children lived in poverty in 2000, which was better than the U.S. average of 17% but higher than the federal benchmark (7%). However, this rate is not equally distributed by race and ethnicity. U.S. Census Bureau, 2000
Why? HW2020 Data Highlights • An analysis by Trust for America’s Health (2008) indicates that the application of evidence-based prevention programs to improve health and prevent disease can provide a 6.2 to 1 return on investment in health care savings for Wisconsin.
Why? HW2020 Data Highlights • A 2009 report prepared by the United Health Foundation lists Wisconsin as 50th out of the 50 states for per-capita state funding of public health.
About Population Data . . . • Population data and information provides a picture that individual data often does not. • Data confirms what we might suspect. • Data reveals what is not always visible. • Population data helps us target interventions, identify individuals and families at-risk, and mobilize informed and collective action with our partners.
What is HW2020? It is Wisconsin’s Public Health Agenda for 2010 – 2020 This agenda serves many purposes
What is HW2020? • An outcome-driven health improvement plan – designed by many to be implemented by all • An agenda anchored in Wisconsin Statute s. 250.07 (1) (a) • A strategic approach to align the partners to improve health where we live, grow, work, learn and play • A plan to align policies and systems for better health
What is HW2020? • A list of Focus Area Objectives directly tied to the HW2020 goals that: • Span health and infrastructure • Are crosscutting • Are measurable and outcome-driven • Foster integrated thinking and action by the partners described in the HW2020 Partnership Model
What Tools and Documentsare Available? • Main plan - Healthiest Wisconsin 2020: Everyone Living Better, Longer • 23 Focus Area Profiles • Implementation Plan for 2010 – 2013 • HW2020 Endorsement Form (being revised) and will be reposted on-line http://www.dhs.wisconsin.gov/hw2020/index.htm
Critical Messages of HW2020 • Message 1 -Health begins in our families, neighborhoods, schools and jobs. • Message 2 -Every person, organization and community plays a role in shaping, improving and protecting the health of individuals and families. • Message 3 –We all have a responsibility to strengthen and protect communities where we live, learn, grow, work and play.
Critical Messages of HW2020 • Message 3-Building and sustaining partnerships is a necessary ingredient to building healthy communities and successful economic development. • Message 4-The journey to success begins with the first step: Act Now.
Vision Everyone Living Better, Longer Mission Assure conditions in which people can be healthy and members of healthy, safe and resilient families and communities What is the HW2020 Framework?
Shared Accountability Alignment Collaboration Community assets Evidence Fairness Infrastructure Justice Leverage Performance Improvement Prevention Science Shared Leadership Framework: Values / Principles
Framework: Goals • Improve health across the lifespan • Eliminate health disparities and achieve health equity
Framework: Focus Areas and Objectives • 23 Focus Areas with objectives • Each objective is directly tied to one of the HW2020 goals • The focus areas and objectives span 3 categories • Crosscutting • Health • Infrastructure
Infrastructure, Health, Overarching Interdependent / Connected Focus Areas Crosscutting Focus Areas (2) Infrastructure Focus Areas (9) Health Focus Areas (12)
Reduce disease, injury and adverse health conditions due to risky behaviors Reduce preventable illness and disability Reduce preventable death Align policies & systems for better health Eliminate disparities Achieve health equity Balance policies and actions based on all 4 drivers of health Framework: Outcomes
Determinants of Population Health Health Across the Life Span Eliminate Health Disparities and Achieve Health Equity Reduced Mortality, Morbidity, and Disability Health Outcomes Health Behaviors and Skills Social, Economic and Educational Factors Health Services and Systems Physical Environment Health Factors or Determinants Policies and Programs Adapted with modifications from University of Wisconsin School of Medicine and Public Health, “Mobilizing Action Toward Community Health, County Health Rankings,” accessed at http://www.counthealthrankings.org/about-project/background
Determinants of Health Individual-level health education efforts Health Outcomes Determinants of Health Health-supporting systems Healthy environments Employment Education Housing Income
Determinants of Health Individual-level health education efforts Determinants of Health Inadequate systems Health Outcomes Unhealthy environments Unemployment Lack of education Poor Housing Poverty
HW2020 Framework In Brief • Vision • Goals • Values • Goal 1 Goal 2 • Focus Areas and Objectives • Crosscutting Health Infrastructure • Outcomes
Where Will You Find HW2020? • Potentially everywhere an individual, agency or organization aligns to the HW2020 agenda. • Find it in the places the partners carry out their work: • government, tribal, public, private, nonprofit, voluntary, faith communities, legislature, civic society and many more at local, regional and statewide levels • It take the work of many to improve the health of all.
Assess strengths needs & resources Evaluate & report results Engage community partners Healthy People in Healthy Wisconsin Communities Implement strategies Select priorities & align to HW2020 Find / use programs & policies that work HW2020 Action Model • Taking Action / Making a Difference
How Do I Get Started? Use the HW2020 Action Model to take systematic action and make a difference: • Assess strengths, needs and resources your community partners. • Select priorities and align to HW2020 using theEndorsement Form. • Find and use programs and policies that work. • Implement strategies with your partners and the community. • Evaluate efforts and report results.
Additional Slides • Options for Creating Synergy • and Achieving Deeper Effects • By • Combining Focus Area Objectives
MENU FEATURES of HW2020 • Option 1:Select a health objective (alone or in combination with other health objectives). • Option 2:Select an infrastructure objective (alone or in combination with other infrastructure objectives). • Option 3:Select and combine a health, infrastructure and a pillar objective.
MENU FEATURES of HW2020 • Option 4:Select and combine a health and a pillar objective. • Option 5:Select and combine an infrastructure and a Pillar Objective. • Option 6:Select a Pillar Objectives (or combine Pillar Objectives).